Healthcare Provider Details

I. General information

NPI: 1013829894
Provider Name (Legal Business Name): LYNZI FEASTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 COLLEGE AVE
ASHLAND OH
44805-3799
US

IV. Provider business mailing address

7568 DORSEY MILL RD SE
HEATH OH
43056-9276
US

V. Phone/Fax

Practice location:
  • Phone: 419-521-6854
  • Fax:
Mailing address:
  • Phone: 740-616-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: